End-stage kidney failure

There are different types of kidney dialysis. This article focuses on hemodialysis.

What is Hemodialysis?

Your kidneys' main job is to remove toxins and extra fluid from your blood. If waste products build up in your body, it can be dangerous and even cause death.

Hemodialysis (and other types of dialysis) does some of the job of the kidneys when they stop working well.

Hemodialysis can:

Remove extra salt, water, and waste products so they don't build up in your body

Keep safe levels of minerals and vitamins in your body

Help control blood pressure

Help produce red blood cells

During hemodialysis, your blood passes through a tube into an artificial kidney, or filter.

The filter, called a dialyzer, is divided into 2 parts separated by a thin wall.

As your blood passes through one part of the filter, special fluid in the other part draws out waste from your blood.

Your blood then goes back into your body through a tube.

Your doctor will create an access where the tube attaches. Usually an access will be in a blood vessel in your arm.

When to Start Dialysis

Kidney failure is the last stage of chronic kidney disease. This is when your kidneys can no longer support your body's needs. Your doctor will discuss dialysis with you before you need it. Usually you will go on dialysis when you have only 10 to 15% of your kidney function left.

You may have fewer symptoms from dialysis such as nausea, headaches, cramps, and tiredness.

You can more easily fit treatments into your schedule.

You can do the treatment yourself, or you can have someone help you. A dialysis nurse can train you and a caregiver on how to do home dialysis. Training can take a few weeks to a few months. Both you and your caregivers must learn to:

Handle the equipment

Place the needle into the access site

Monitor the machine and your blood pressure during treatment

Keep records

Clean the machine

Order supplies, which can be delivered to your home

Home dialysis is not for everyone. You will have a lot to learn and need to be responsible for your care. Some people feel more comfortable having a provider handle their treatment. Plus, not all centers offer home dialysis.

Home dialysis may be a good option if you want more independence and are able to learn to treat yourself. Talk with your doctor. Together, you can decide what type of hemodialysis is right for you.

When to Call Your Doctor

Call your doctor if you notice:

Bleeding from your vascular access site

Signs of infection, such as redness, swelling, soreness, pain, warmth, or pus around the site

A fever over 100.5°F (38.0°C)

The arm where your catheter is placed swells and the hand on that side feels cold

Your hand gets cold, numb, or weak

Also call your doctor if any of the following symptoms are severe or last more than 2 days: